NPIMap

Organization Active NPI

Genesis Family Center

  • Community/Behavioral Health Agency
  • Fresno, CA
National Provider Identifier
1578748158
Registry record updated Jan 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
100043AN Issued in CA
Legal business name
GENESIS FAMILY CENTER
Practice address
1260 N Mariposa St
Fresno, CA 93703-3940
Phone
(559) 233-3246
NPI assigned
Jan 2, 2008
Last updated
Jan 2, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
GENESIS SUBSTANCE ABUSE SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 2, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miss Tongia Sullivan, BA SOCIAL WORK
Title
Program Coordinator
Phone
(559) 439-5437

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 100043AN CA Primary

Addresses

Primary practice location

1260 N Mariposa St
Fresno, CA 93703-3940

Mailing address

1260 N Mariposa
Fresn0, CA 93703
Phone (559) 233-3246

Other identifiers 1

IdentifierTypeStateIssuer
00000000OtherCAMEDI-CAL

Other names 1

  • GENESIS INC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Promesa Behavioral Health-Enhanced Isfc39 organizations share this tax ID, including this one
Part of
Promesa Behavioral Health-Enhanced Isfc

Other organizations with this tax ID 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

Locations

1260 N Mariposa St
Fresno, CA 93703
Phone (559) 233-3246

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1578748158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 N MARIPOSA",
            "city": "FRESN0",
            "state": "CA",
            "postal_code": "93703",
            "telephone_number": "559-233-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 N MARIPOSA ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937033940",
            "telephone_number": "559-233-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS FAMILY CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENESIS SUBSTANCE ABUSE SERVICES",
        "enumeration_date": "2008-01-02",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "TONGIA",
        "authorized_official_title_or_position": "PROGRAM COORDINATOR",
        "authorized_official_telephone_number": "559-439-5437",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "BA SOCIAL WORK"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "100043AN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00000000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GENESIS INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.